Background
Several studies have investigated the effect of non–vitamin K antagonist oral anticoagulants (
NOAC
s) in atrial fibrillation (
AF
) patients with cancer, but the results remain controversial. Therefore, we conducted a meta‐analysis to compare the efficacy and safety of
NOAC
s versus warfarin in this population.
Methods and Results
We systematically searched the PubMed and Embase databases until February 16, 2019 for studies comparing the effect of
NOAC
s with warfarin in
AF
patients with cancer. Risk ratios (
RR
s) with 95%
CI
s were extracted and pooled by a random‐effects model. Five studies involving 8908
NOAC
s and 12 440 warfarin users were included. There were no significant associations between cancer status and risks of stroke or systemic embolism, major bleeding, or death in
AF
patients. Compared with warfarin,
NOAC
s were associated with decreased risks of stroke or systemic embolism (
RR
, 0.52; 95%
CI
, 0.28–0.99), venous thromboembolism (
RR
, 0.37, 95%
CI
, 0.22–0.63), and intracranial or gastrointestinal bleeding (
RR
, 0.65; 95%
CI
, 0.42–0.98) and with borderline significant reductions in ischemic stroke (
RR
, 0.63; 95%
CI
, 0.40–1.00) and major bleeding (
RR
, 0.73; 95%
CI
, 0.53–1.00). In addition, risks of efficacy and safety outcomes of
NOAC
s versus warfarin were similar between
AF
patients with and without cancer.
Conclusions
In patients with
AF
and cancer, compared with warfarin,
NOAC
s had lower or similar rates of thromboembolic and bleeding events and posed a reduced risk of venous thromboembolism.
The aim of this study was to evaluate the association of the body mass index (BMI) categories with the risk of sudden cardiac death (SCD) in a systematic review and meta-analysis. We systematically searched the PubMed, Embase, and Cochrane Library databases up to February 2018 for all studies reporting an association between BMI and risk of SCD. Relative risks (RRs) and 95% confidence intervals (CIs) were extracted and pooled using a random effects model. A total of 10 studies involving 1,381,445 participants were included in the meta-analysis. Overall, compared with the risk level in normal-weight controls, being underweight was not associated with increased risk of
Although several studies have assessed the effect of non‐vitamin K antagonist oral anticoagulants (NOACs) relative to that of vitamin K antagonists (VKAs) in patients with left ventricular thrombus, the results remain controversial. Herein, a meta‐analysis was performed to compare the effectiveness and safety of NOACs versus VKAs for the treatment of left ventricular thrombus. We systematically searched the Cochrane Library, PubMed and Embase databases until November 2020 for studies that compared the effects of NOACs versus VKAs in patients with left ventricular thrombus. The treatment effects were expressed as odds ratios (ORs) with 95% confidence intervals (CIs) and pooled by a random‐effects model. Seven retrospective studies involving 865 patients with left ventricular thrombus (266 NOAC and 599 VKA users) were included. The pooled analysis suggested no difference in the rate of thrombus resolution between the NOAC and VKA groups (OR = 0.83, 95% CI 0.61–1.13). There were also no differences in the rates of stroke or systemic embolism (OR = 0.62, 95% CI 0.20–1.97), bleeding events (OR = 0.73, 95% CI 0.37–1.45), or all‐cause death (OR = 0.92, 95% CI 0.50–1.69) between patients treated with NOACs and those treated with VKAs. In addition, the rates of thrombus resolution, stroke or systemic embolism, bleeding events, and all‐cause death between NOAC‐ and warfarin‐treated patients were also similar. Our current evidence suggested that NOAC and VKA users had similar rates of thrombus resolution and clinical outcomes among patients with left ventricular thrombus. Further large‐scale prospective studies should confirm our results.
Objective:
This study evaluated the clinical value of drug-coated balloons for patients with small-vessel coronary artery disease (SVD).
Methods:
A computerized literature search was performed using the databases to conduct a meta-analysis and evaluate the clinical value of drug-coated balloons among patients with SVD.
Results:
This review enrolling 1545 patients receiving drug-coated balloons and 1010 patients receiving stents (including drug-eluting stents and bare-metal stents). The meta-analysis results showed that the incidence of major adverse cardiovascular events among patients with SVD did not significantly differ between the drug-coated balloon group and the stent group within 1 postoperative year (odds ratio = 0.81,
P
= .5). A subgroup analysis showed that the incidence of myocardial infarction among the drug-coated balloon group was significantly lower than that among the stent group (odds ratio = 0.58,
P
= .04). Nevertheless, the late lumen loss of the drug-coated balloon group was significantly lower than that of the stent group (mean difference = 0.31,
P
= .01).
Conclusions:
Drug-coated balloons can be used to effectively reduce the incidence of myocardial infarction in patients with SVD within 1 year and decrease the extent of late lumen loss without increasing the incidence of major adverse cardiovascular events.
With the density functional first-principles calculations, we investigate the structures and electronic properties of transition metal nickel and its (111) surface. The adsorption behavior of single C atom on Ni (111) surface and its co-adsorption with the another C atom on Ni (111) surface are studied. The calculations on band structure and density of states show that significant spin polarization exists at the Fermi level of both nickel and its (111) surface. By comparing the adsorption energy, we find that the hollow site of hexagonal close-packed on the second layer of Ni atoms is the most stable position for the first C atom adsorption, and the hollow site of face-centered cubic on the third layer of Ni atoms is the most stable site for the co-adsorption of second C atom. Charge analysis shows that 1.566e charge transfers from each C atom to the adjacent Ni atom, which is similar to the 1.68e charge transfer in the first C atom adsorption case. The calculations on magnetism show that the magnetic moments of the two C atoms in co-adsorption are 0.059B and 0.060B, respectively, which are larger than the magnetic moment 0.017B of single C atom in Ni (111) surface.
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